Sex and Gender-based Analysis of this topic
Definition
Age of smoking initiation is defined as the age at which a person first uses cigarettes. Age of smoking initiation is an important indicator of health due to increased risks of becoming addicted, difficulties quitting, and the development of tobacco-related health problems the younger a person is when he or she begins smoking [1].
Examples of health problems associated with early smoking initiation include a higher risk of lung cancer [2] and, a higher susceptibility to lung damage [3], among many others. In Canada, out of the population aged 12 and over who reported being either a current smoker or former smoker, the majority of people initiated smoking between the ages of 15 and 19 (50%), followed by those in the 12-14 age range (29%). Eight percent try cigarettes for the first time between the ages of 5 and 11 [4]. Smoking initiation before the age of 13 years of age is especially problematic as it has been linked with significant health risks and premature mortality [5].
Sex Issues
A younger age of smoking initiation, and its association with a higher amount of smoking over the lifetime, is especially dangerous as women have a higher biological susceptibility to the toxic effects of smoking than men and therefore are at a greater risk of developing chronic diseases, such as chronic obstructive pulmonary disease (COPD) and lung cancer [6][7]. For example, women who smoke the same amount as men are more likely to develop lung diseases earlier and to have more severe cases of the disease [8][9]. Additionally, smoking may have detrimental effects on women’s reproductive function including decreased fertility and early menopause [10].
Gender Issues
The age of smoking initiation varies for males and females and is most likely a result of gendered societal roles. Out of the population aged 12 and over who reported being either a current smoker or former smoker, boys between the ages of 5 and 11 are nearly twice as likely to have initiated smoking than girls, however by the 12-14 age range the gender difference nearly disappears. By ages 15 and older, more girls are likely to initiate smoking then boys [4]. Additionally, some of the reasons that girls start to smoke are different compared to boys’ reasons. These self-reported reasons include influences from family and friends’ smoking behaviour as well as media messaging and in an effort to deal with stress [11].
Diversity
Research has shown that there are significant differences in age of smoking initiation for some Canadian subpopulations. Aboriginal youth are more likely to have a younger age of smoking initiation than non-Aboriginal youth; 52% of on-reserve First Nations people who smoke started smoking between the ages of 13 and 16 [12]. The prevalence of teenage (aged 12-19) smoking is also exceptionally high among Inuit people, with almost half (46%) of teens initiating smoking at age 14 or younger [13]. While smoking initiation rates are similar between recent and long-term European immigrants and the general Canadian population, both recent and long-term rates for non-European immigrants are significantly lower than the general Canadian population [14]. Furthermore, research findings suggest that immigrants who are more acculturated to Canada are at higher risk of initiating smoking [15]. Additionally, female Ethiopian immigrants to Canada have higher post-migration smoking rates than male immigrants [16].
Critique
Age of smoking initiation is an important indicator of women’s health due to the associated health burdens of early smoking. Interventions aimed at delayed age of smoking initiation have a large potential to improve health outcomes, health system costs, and balance inequalities that exist between different population groups. Additional research is needed to understand the best interventions to attain this goal, as well as to more accurately assess the populations groups in greatest need.